Regulated
by RICS

Published Articles

Andrew
McLeman - Apparently now the number 1 authority
on the cost implications of single bed hospital wards!!!!

In
June 2008 just after the Scottish Government announced that any
new hospital build would, to help combat MRSA and the like, only in
the future havesingle
bed rooms and no multi bed wards, a "Scotland on
Sunday" newspaper journalist phoned me late afternoon on a
Friday (was I the only QS still at my desk at that time?)
for a comment from a Professional Construction Cost Consultant on
the cost implications of this decision was likely to have.

Coming
at it cold I however In a ten minute conversation considered various
items such as the extra circulation requirements, the extra
sanitary appliances etc, and the more inefficient shape - e.g.
narrower wings to achieve single room outside windows, and so a
greater external floor to wall ratio and more land required to
build.

I
discussed also that designers would have to be as ingenious as the
could be to make it work, but that retrofitting, if that was the
next stage , would be considerably more problematical. I thought
on the whole it would be a good idea, and any extra building costs
would be recouped fairly quickly in savings in less disease
control.

I
was put on the spot to say how much extra this was likely to be,
and acknowledging that wards/rooms are only part of any ward
equation, and that efficiencies would be found, I came up with a figure I
thought was realistic of 10%.extra.

Of
course this 10% is what the Scotland on Sunday (front page!)
article homed in on, and repeated almost verbatim in the next days
Daily Mail including
my quote. I even thought my "well consideredinitial"
figure might be shot down in flames, or raised a discussion
somewhere? - but no ...it seems that it was accepted by
everyone without any dissention!

Then
as a result of this initial interview, I was approached by the
magazine "Public
Service Review" to include
200 words for their April 2009
issue on various aspects of single bed versus
four or more bed wards, repeated below. As now I appear to be the
primary "expert" on this subject, it is presumably only
a matter of time till I get my TV break! !

Single rooms only to beat NHS superbugs

Published Date: 29 June 2008

By Kate Foster

ALL new hospitals in Scotland are to be built with private rooms for every
patient in a bid to halt the spread of deadly superbugs.

Traditional wards will be phased out to reduce the risks of
patients catching potentially fatal hospital-acquired infections such as MRSA
and Clostridium difficile.

The move follows an outbreak of C diff that caused the deaths of nine patients
at the Vale of Leven Hospital and contributed to the deaths of nine more,
while five babies in a special care unit in Paisley have tested positive for
MRSA.

But experts warned last night that the single-room policy would increase the
cost of building hospitals by around 10%, as well as raising running costs.
There is also a debate over whether private rooms will significantly cut
infection rates.

The new building for the Southern General Hospital in Glasgow, which has more
than 1,000 beds and is due to open in 2014, will contain private rooms only.
Health Secretary Nicola Sturgeon told Scotland on Sunday: "We are very
keen to move to single wards."

But Professor Allyson Pollock, head of the Centre for International Public
Health Policy at the University of Edinburgh, said: "There is no strong
research evidence that moving to single rooms is conducive to health and
better outcomes or reducing the infection rate. Single rooms do not deal with
hospital hygiene measures."

Andrew McLeman, a surveyor who has overseen large building projects, said a
hospital with single rooms would cost around 10% more to build.

"It would be a less efficient use of space, would need more land and more
circulation room," he said.

Public
Service Review Article-
April 09

A Ward
1950's Style

"There
are a number of cost implications in designing for single
room over four or larger bed wards. The first pressure on
costs for a single bed is on floor area as the shared
circulation space in a four bed ward has to be provided
exclusively in a single room, plus the extra area for an
ensuite toilet rather than a shared facility.

As bed
spaces are only part of the equation in hospital wards
designers are likely with ingenuity by adjusting ancillary
areas to be able to achieve this within or close to
existing area allowances. It is the other influenceson
costs such as extra doors, sanitary equipment and services
provision that will however inevitably put substantial
pressure on achieving this within the existing cost
allowances.

The
requirement to have windows in each single room will also
mean that a narrower plan shape will be required resulting
in a less efficient and therefore more expensive greater
external wall to floor ratio, plus a larger footprint and more
site area.

The
savings on costs due to reduced Healthcare associated
infections, additional flexibility, easier access and
shorter patient stays should however provide lifetime
benefits well in excess of these fairly minor additional
building costs."

Andrew
McLeman FRICS RMaPS

Chartered
Quantity Surveyor

McLeman
QS Network

We now have a Firm's facebook
page, where is lots of up to date news from our
current
projects.

The
Royal Household have recently commisioned us for a third
CDM-C project at the Palace of Holyroodhouse. The latest is
for a quick refurb ot the Queen's Gallery

Belhaven
Hill School at Dunbar has recently appointed us as CDM-C
for a conversion of their staff accommodation.

We
are pleased to be ithe QS on a £650K conversion to a listed
building in Elie for a private client.

Co-iincidentally
we have four CDM-C projects in Merchiston. The first
is the conversion of the North Merchiston Club, the
second is the new tennis courts for Merchiston
Bowling and Tennis Club , the other two are
projects at Merchiston campus of Edinburgh Napier
University one being a new entrance canopy and the other
the third phase of their re-roofing programme..

About
to start on site is a fire damage reinstatement of a
tenement property in Bellshill where we are QS and CDM-C for
the joint owners.

At
Milnathort we are both QS and CDM-C for a development for Ross
Country Homes, where we are also undertaking the bank
monitoring role.

The
Bourse in Leith is a commercial development where we are
CDM-C and QS for a stone fabric repair.

After
12 years as a Sole Trader we have now incorporated as a
Limited Company Registered in Scotland Nr SC396395.
McLeman QS Network Ltd.

"By
Royal Appointment"!-
It may only be a fairly small project at the cafe at
Holyrood House in Edinburgh, however we are very honoured
to have secured a CDM-C commission from "The
Royal Household."

We are
now well into our CDM-C Framework commission which runs till
late 2012 with West Lothian Council Construction
Services. We have already undertaken a new £1m visitor
Centre at Beecraigs, a number of demolition projects, a War
Memorial, plus the more usual housing and schools projects.

Weslo
Housing Management appointed us for a third year for both QS and CDM service to take forward their
2011-12
maintenance programme, which include 9 projects with a
value of £1.25m.

Andrew
McLeman quoted in the Scotsman and then asked to
pen an article for a Health Publication on the cost implications of having only
single bed rooms in future Scottish hospitals - see
the articles here

Recently
completed are two £1m house extensions/
refurbishments The first near Loch Lomond and
the second one in East Lothian.

The
Benjamin Tindall designed Luffness Castle extension is now
complete and the Z1 Youth Bar for Girvan Youth Trust has
recently opened to rave reviews.